As posted below, I joined HealthTap a month ago, impressed with its vision of bringing real medical expertise to the public in a Yahoo Answers type format. Since then I’ve participated actively. As of today, I’ve answered 40 questions, and I’ve been thanked by 30 members — it’s tempting to call them patients, but they’re not. Other physicians have agreed with my answers 60 times; I’ve agreed with some of theirs as well. HealthTap claims I’ve helped over 4000 people; I have no idea how they calculate that. I’ve earned 3600 points and 13 rather trivial “awards” by virtue of my activities, granting me “Level 7” status as a “Leading Medical Expert.” I haven’t yet used the mobile app or social networking links (i.e., to Facebook, LinkedIn, or Twitter), nor have I written “tips” or “health guides,” collections of answers and tips under a defined theme. I also haven’t done much with the networking feature: I “follow” one other psychiatrist, and eight physicians follow me, which basically means they find out immediately if I post something (and their dedicated readers see it as well, like a Facebook “wall”). Today, HealthTap reposted my piece on support and insight in therapy to their blog.
All in all, it’s been fun. The awards, points, and “levels” are a bit silly, but they add some zing. Answering questions in 400 characters isn’t as hard as I expected, and part of the fun is deciding what to say in so few words. It’s also interesting to read what other MDs write, especially in fields other than mine. And it does feel nice to volunteer simple answers to real questions people have.
HealthTap democritizes medical knowledge, and brings the public closer to instant “ask your doctor” convenience than other health sites I’ve seen. But looming over the enterprise is the reality that we are not “your” doctor. The terms of service and legal disclaimers underscore that no doctor-patient relationship exists via the site, and that medical answers are intended to be generic, not for an individual. But patients, I mean members, mostly ask first-person questions that address their personal medical concerns. That’s the whole idea. And very often we doctors reply that there are many possible diagnoses or etiologies to consider, but that only an in-person medical evaluation can sort them out.
While HealthTap is an inspired effort, in my opinion it is hampered by the wrong model. It tries to be a social networking site, when in reality it’s a knowledgebase. Social networks derive value from interconnected communications among members; think Twitter and Facebook. But people don’t chat about health issues on HealthTap, nor do they befriend others. They seek answers to questions. HealthTap’s social network model encourages asking the same questions over and over, since quick access to doctors is emphasized, not the fact that thousands of questions have already been answered. For example, in my one month on the site several members have asked how to treat anxiety. It’s a good generic question, but it’s already been answered a number of times — at least as well as one can answer such a broad question in 400 characters.
HealthTap encourages doctors to create a Virtual Practice to “enhance your reputation, get new patients, and improve practice efficiency.” I don’t quite see the utility, but perhaps this works better for other specialties. I can imagine a family physician pointing real patients to his or her HealthTap page for tips or guidelines about common complaints.
I think HealthTap would serve its members better by embracing the knowledgebase model. Make prior questions and associated answers more easily searchable, and give searching priority over asking anew. If a user’s specific question is not found, it could be submitted to HealthTap staff for vetting. Duplicate or incoherent questions could be rejected, grammar and spelling cleaned up, and meaningful tags added to facilitate retrieval later. To encourage participation, doctors could still be recognized for answering quickly or often, or with answers colleagues agree with. Thanks could still be offered by members for helpful answers, and everyone could still log into personalized pages as they do now.
HealthTap is reportedly popular and growing rapidly. HealthTap Express, the mobile app, is the #1 Staff Pick on Android Market. As long as people seek health information online, and as long as doctors volunteer to provide it, HealthTap’s future seems bright. But it could be so much more if its architecture better matched its primary purpose. Social networks are great for social networking. Knowledgebases are great for organizing, storing, and retrieving knowledge. The doctor-patient relationship, a small social network, cannot exist on HealthTap, but a great deal of medical knowledge already does. Its organization and accessibility could be greatly enhanced without sacrificing the responsiveness and personalization that brings smiles to the HealthTap team and its members.